Clinical Study
Eye (2006) 20, 591–594. doi:10.1038/sj.eye.6702000; published online 15 July 2005
Glaucoma detection in the community: does ongoing training of optometrists have a lasting effect?
U D M Patel1, I E Murdoch1,2 and J Theodossiades1,2
- 1Optometry Department, Moorfields Eye Hospital, London, UK
- 2Department of Epidemiology and International Eye Health, Institute of Ophthalmology, London, UK
Correspondence: UDM Patel, Optometry Department, Moorfields Eye Hospital, City Road, Old Street, London EC1V 2PD, UK. Tel: +44 20 7 608 6896; Fax: +44 20 7 250 3207. E-mail: pateluma1@hotmail.com
Received 3 February 2005; Accepted 25 May 2005; Published online 15 July 2005.
Abstract
Purpose
To establish whether the effect of improved glaucoma detection in the community suggested by an intervention study is maintained when intervention is extended to include all optometrists in the area.
Methods
Optometrists' in the Ealing, Hammersmith, and Hounslow area were invited to ongoing training sessions following completion of an intervention study. The number of optometrist initiated referrals to Ealing Hospital Eye Clinic (EHEC) for suspect glaucoma was assessed over a 12-month period. The positive predictive value (PPV) of those referrals was calculated and a historical comparison made with the results of the original study.
Results
A total of 376 new referrals for suspected glaucoma were assessed at EHEC during the 12-month period of data collection. This represents an increase in the number of referrals of 58% compared with an equivalent 12-month period during the initial intervention trial (376 vs238). The PPV was maintained at 0.45 (95% CI 0.41–0.51).
Conclusion
The rising number of new referrals for glaucoma together with maintenance of the PPV suggests an impact on the number of new cases of glaucoma detected in the community. The increase in referral numbers was limited to glaucoma when compared with new referrals for cataract. This implies a targeted effect of the intervention in terms of glaucoma detection. We believe the next step is to perform the study in an alternative location to see if the effect is repeatable elsewhere. If proven to be the case, there is a coherent argument for widespread adoption of this strategy to improve glaucoma case finding.
Keywords:
glaucoma, optometrist, intervention trial, case-finding, positive predictive value
